To investigate the clinical efficacy and safety of direct-acting antiviral agents (DAAs) in patients with hepatitis C virus (HCV)-related liver cirrhosis.

The clinical characteristics and treatment protocols of patients with HCV-related liver cirrhosis in our hospital from January 2015 to January 2016 were analyzed by descriptive method. HCV RNA, liver function, safety and adverse reactions were observed during treatment, respectively.

Total of 24 cases including 10 male and 14 female were collected. The patients were aged 43-77 years old, and the mean age was (56.38 ± 8.99) years old. There were 12 cases with compensated and decompensated cirrhosis, respectively. There were 18 patients with interferon via treated (recurrence of drug withdrawal or could not tolerate). There were 20 cases with genotype 1b, 2 cases with genotype 2a and 2 cases with genotype 3b. HCV RNA ranged from 1.63 × 10³ to 2.72 × 10⁷IU/m1. All patients were treated with DAAs, among whom 4 were treated with sofosbuvir (SOF) + daclatasvir (DCV) + ribavirin (RBV), 6 patients treated with SOF + DCV, 5 patients treated with SOF + ledipasvir (LDV) + RBV, 7 patients treated with SOF + LDV, and 2 patients treated with SOF + RBV. There were 23 patients who completed the treatment and followed for 24 weeks after drug withdrawal while one patient was died of gastrointestinal bleeding during the treatment. All patients achieved rapid virological response (RVR) and end treatment virological response (ETVR). There were 22 (95.65%) patients achieved sustained virologic response (SVR). Liver function were improved after treatment with decreased alanine aminotransferase (ALT) (t = 4.90, P < 0.001) and aspartate amino transferase (AST) (t = 4.24, P < 0.001). While cholinesterase (CHE) was increased (t = 2.30, P = 0.03), alphafetoprotein (AFP) (Z = 2.43, P = 0.02) and Child-Pugh score (Z = 2.06, P = 0.04) were decreased, with significant differences. No significant change of renal function was found. Only slight adverse reactions such as fatigue (5 patients), dizziness (2 patients), headache (1 patient), fever (1 patient), diarrhea (1 patient) and skin rash (2 patients) were observed during treatment. These discomforts were transient and alleviated by oneself, which not affected the treatment.

DAAs were effective and safe in treatment of patients with HCV-related liver cirrhosis. The long-term therapeutic efficacy need to be furtherly evaluated for decompensated liver cirrhosis.